Surgical splint



UTE SATES PA N JOHN CLOUGH AND DANIEL M. CUMMINGS, OF NORTH ENFIELD,NEYV HAMPSHIRE.

SURGICAL SPLINT.

Specification of Letters Patent No. 14,853, dated May 13, 1856.

To all whom t may concern Be. it known that we, JOI-IN OLOUGH and DANIELM.' CUMMAINGS, both of Enfield, in the county of Grafton and State ofNew Hampshire, have invented a new and useful Machine fo-r th-eReduction and Setting of Fractured Limbs, which we call Clough andCummingss Improved Splint and we do hereby declare that the following isa full, clear, and exact description of the same, reference being had tothe annexed drawings, making a part of this specification, in which-Figure 1, is a perspective view of the entire machine. Fig. 2, is a viewof the lower portion or bed-pieces, exhibiting in part the device bywhich the splint is expanded and contracted at the knee for the purposeof adapting it to the size of the limb to be operated upon. Fig. 3, is aview of the lower extension screws with their supports, traversing nutsand their attachments. Fig. 4, is a view of the elevating screw with itssupports, the cross-bar through which it passes, and its connections andattachments. Fig. 5, is a view of one of the upper extension screwsexhibiting' the forni of its head, with the bolster resting in it; whichbears upon the perineum. Fig. G, is a view of one of the lower extensionscrews and its journals or bearings. Fig. 7 is a view of the femur orthigh splint. Fig. 8, is a view of one of the oblique standardscomposing a part of the foot frame. Fig. 9, is a view of the elongatingarbor with the cancave flooring for the support of the femur attached,and also the movable braces constituting a part of the combination forthe elevation and depression of the knee thereby causing a correspondingflexure and extension of the limb. Fig. 10 is a view of the` elongatingarbor with its semi-circular complement, showing a mode for theindefinite extension of th-e arbor. Fig. 11, is a view of one of theclamps used in fastening the femur splint to the leg and femur sidepieces. Fig. 1Q is a view of the wrench used in op? erating the variousscrews. Fig. 13, is a view of the splint as practically applied for afracture of the limb below the knee. Fig. 14C, is a view of the splintas practically applied to the limb for a fracture, or dislocation, ofthe thigh. Fig. 15, is a view of the brass straps placed on each side ofthe ma chine at the joint corresponding with the knee, with slots ateach end for the reception of straps attached to bandages applied aboveor below the knee.

The various letters represent identical parts of the machine in all thevarious tigures.

A, A', are the leg side pieces of the splint below the joints R, R. Forlightness and convenience we make them of firm and durable wood, twofeet four inches in length, one and a fourth inches in depth, and threefourths of an inch in width.

F, F, are the upper femur side pieces, made also of suitable wood, seveninches in length, and of the depth and thickness of A, A, to which theyare connected by the joints BLR.

B, C, D, are the bed-pieces, made of the same material, two feet eleveninches in length, B, and D, being one and a tenth inches in depth andone and a fourth inches in width at their extremities, and C, being oneand a tenth inches in depth and two inches in width. The bed-pieces B,and D, are connected with the leg side pieces A, A, by the braces t, t,and the supports m, m, and with the femur side pieces F, F, by thelsupports 0, 0, and the bed-piece O, is connected with the cross-bar M,by the supports y, y and the elevating screw c, and by them, with theleg` side pieces A, A.

E, is the femur or thigh splint, constructed of strong and durable wood,three feet in length, one and a fourth inches in depth, and threefourths of an inclrin width.

G, is an adjustable cushion of wood, attached to the femur splint E, bythe clamp n at the lower end, and in the upper end having a wooden ormetal pointl projecting from the back side, which moves in the groove ss. 'It may be made in the form represented in Fig. 7, live inches and ahalf in length, and two and a half inches in width; or the form anddimensions, and material may be varied as may be deemed best by theoperator.

H, is a stationary cushion, of wood, permanently attached by screws tothe upper end of the femur splint E, ten and a quarter inches in lengthand two and a half inches in width, having at its upper end two slots orapertures t t, t t, for the reception of straps attached to bandages.The form, dimensions, and material, of this cushion may also be variedat the pleasure of the operator.

I, I, are oblique standards composing thel sides of the foot rest, orframe, attached by the clamps a, a', to the leg side pieces A, A', uponwhich they are movableandmay be firmly fixed by means of the thumbscrews g, g', as the length of the limb operated upon may require. Theymay be made of wood, and should project six inches and a half from theleg side pieces A, A'

P, is a wire bow attached to the oblique standards I, I', by the staplesz, a', and assists in protecting the foot from the weight of the bedclothes.

` J, is a cross-bar at the foot of the splint, six and a half inches inlength, which connects the leg side-pieces A, A', to the ends of whichit is confined, not very firmly, by screws, or by tenons and mortises.It also supports the head bearings of the lower extension screws c, e',both of the latter passing through it. K, is another cross-bar, in whichthe extreme bearings of the lower extension screws c, e', are supported.Its tenons a a, a a', rest in loose mortises in the leg side pieces A,A', in order to allow of the expansion and contraction of the splint forthe admission of limbs of diiferent sizes.

e, e' are what we denominate the lower extension screws. They are madeof brass three and three fourths inches in length and one fourth of aninch in diameter, confined to the cross-bar J by the nuts or washers.They are used for the purpose of extending the limb, when fracturedbelow the knee, to

that degree of tension which will enable the operator to adjust thefracture without difliculty.

y', j', 4are traversing nuts afiixed to the screws e, e', upon whichthey are movable, to which are attached the inferior extension straps m,connected by the buckles n n, n n', to the superior extension straps m"00"', which are attached to the bandages Q.

76, k', are brass guides for the direction of the traversing nuts y',j'.

z', e", are brass supports for the bearings of the lower extensionscrews c, e', the screws and their various attachments and appendagesbeing distinctly shown'in Figs.` 3, and 6, and the practical applicationand operation of the same in Fig. 13.

M is a cross-bar attached by the cross supports b, b', to the leg sidepieces A, A', having in its center a nut or female screw b b, throughwhich the elevating screw c, and upon which the cross-bar and nuttraverse backward and forward, forming with the leg side pieces A, A',the femur side-pieces F, F', the joints R, R', the elongating arbor T,the concave flooring N, the supports m, m', and 0, o', and the braces t,t', and its own supports y, y', the combination or device by which theleg side pieces A, A', and the femur side pieces F, F', are raised anddepressed, causing corresponding elevations and depressions of the limboperated upon,

at the knee joint, as the ease and comfort of the patient may require.

C, is the elevating screw, which, with its supports, nut, and cross-barM, is more distinctly seen in Fig. 4. lts length is five and threefourths inches, and its diameter three eighths of an inch. It is also ofbrass, and in form precisely like the elongating screws e, e', as seenin Fig. 6.

f, f', f", are the heads of the screws e, e', and c, constructed in suchform as to lit the apertures in the wrench shown in Fig. 12.

p, p, represent the superior and f f, the inferior bearings of the samescrews.

u u is the cap by which the superior bearing of the screw c, is confinedto its support y'. The supports y, y', the cap u u, the support-s b, b',and the nut o b, should be made of brass or other suitable metal.

CZ d, Z d', are mortises in the cross bar J, through which correspondinglevers upon the leg side pieces A, A', pass, of sufficient size to allowof slight lateral mot-ion in the cross-pieces.

a a, a a', are tenons upon the cross-bar K, inserted in correspondingmortises in sidepieces, A, A', of sufficient size to allow of the easylateral motion of the side pieces upon the tenons when necessary toexpand or contact the splint.

R, R, are joints constructed like the joint of the common carpentersrule, connecting the leg side pieces A, A', with the femur side lpiecesF, F', in precise juxtaposition with which the knee joint of the patientshould be placed when his limb is operated upon.

1', r', are what are denominated the upper elongating screws. They areconstructed o f brass, or other suitable metal, and are ive inches inlength, and four tenths of an inch in diameter. They pass through thebrass nuts m, m as', into the extremities of the femur side pieces F,F'. They are constructed with a circular' opening on their heads toadmit the tenon of the bolster L, and with circular openings on thesides of their heads for the admission of the extremity of the handle ofthe wrench by which they are operated. The form of their construction,together with that of the bolster L, may be more distinctly seen in Fig.5.

L, is a bolster of wood, resting against the perineum, the tenon ofwhich is inserted in either of the upper extension screws as the rightor left thigh is operated upon, and aiding in its extension.

N, is a concave flooring for the support of the femur, to which isattached a brass lip g g, by which it is confined to the elongatingarbor T. n

m, m', are brass supports projecting two and three fourths inches fromthe joints R, R', at the lower extremities of the femur side pieces F,F', to which the upper ends are firmly fixed, the lower ends serving assupports for the bearings u, u', of arbor T.

0, o', are brass supports projecting three and a half inches from thelower side of the upper extremities of the femur side pieces F, F', inwhich their upper ends are firmly fixed, their lower ends being confinedto the bed-pieces B, and D, by the screws o o, 0 0", the latter serving`as axes upon which they partially revolve.

T, is what we denominate an elongating arbor, composed in ordinary casesof the two pieces fw, w', constructed of iron or steel, in the form ofhalf cylinders nearly their whole length, as seen in Figs. 9 and 10.)Vhen necessary for greater elongation in order to accommodate thesplint to a large sized limb, we insert another half cylinder Q g, asseen in Fig. 10. The various parts of the arbor are compressed togetherfirmly by the clamps m m, m m', operated by the thumb screws fu, o'.They serve also to confine the lip g g, projecting from the concavefiooring N.

u, u', are the spiral bearings of the arbor T.

t, t', are elevating braces, of brass, four and three fourths inches inlength, attached at their upper extremities to the bearings u, u', uponwhich they partially turn as upon axles, the lower extremities beingattached to the bed pieces VB, and D, by the screws Z Z, Z Z', uponwhich they partially revolve.

s, s', are nuts by which the upper ends of the braces t, t', areconfined to the bearings u, u'.

The arbor T, with its various parts and connect-ions, together with theconcave flooring N, are more particularly shown in Figs. 1, 9, and 10.

s s is agroove in the thigh splint E, in which the cushion G, is made tomove, and to adapt itself to the limb operated upon, as seen in Fig. 7.

'17 n', are clamps used for rmly confining the thigh splint E, to eitherof the side pieces F, F', as the right or left leg is operated upon.

n" is the clamp by which the cushion G, is adjusted and confined to thesplint E.

ZL, 7L', h', &c., are strips of strong cotton cloth passing through theslots um, ui", u", &c., in which their ends are confined by pins passingthrough the leg side pieces A, A', as represented by the points seen ontheir upper surfaces. They serve as the bed on which the limb reposeswhen the splint is applied. h h, is also a strip of strong cotton clothpassing through slots e' z', z' i', in the oblique standards I, 1', andconfined in the same manner. foot.

V, V', are brass straps with slots for the It serves as a rest for thereception of attachments to bandages, fastened by screws, or rivets atthe lower ends of the femur side pieces F, F, upon which they areallowed to revolve wholly, or partially, as necessity or convenience mayrequire. A view of the form of one of them is given in Fig. 15.

(Z is an elongated tenon passing entirely through corresponding mortisesin the bed pieces B, C, and D, to which the bed pieces. B and D, areconfined by the pins r 1, r r', and upon which they partially turn, asit may be necessary for the expansion or contraction of the upperportion of the splint. In order to allow of this motion of B, and D, itis necessary that the latter should be confined to the tenon CZ, at asufficient distance from C, and that the mortises through which thetenon passes should be loose enough to admit of free and easy motion.

y' y', j j', are double elongated tenons permanently fixed in bed piecesB, and D, and passing through the mortises w w, (which should besufficiently loose to admit of easy motion) in the bed piece C, by whichthe bed pieces B, and D, may be expanded or contracted, as may berequired for the admission of the limb to be operated upon, the tenonsbeing fastened at the necessary point by the confining pin ,7a k, thetenon (Z, and the tenons j y', j j', and their mode of operation aremore particularly represented in Fig. 2.

Q, is the ankle bandage connected by straps and (one of which only isseen) to the straps and 0a' attached to the reversing nuts j, j', bywhich the lower lip is extended, as seen in Fig. 13.

O, is the bandage applied below the knee when necessary for theextension of the lower leg as seen` in Fig. 13, and above the knee whennesessary for the extension of the thigh, as seen in Fig. 14.

S, S', (the latter not being seen) are straps attached. to the upperedge of the bandage O on the sides of the limb, and pass through theslots e' z' z', z' z' z", (the former only being represented) in whichthey are confined by wires or buckles as may be deemed best.

.e z, e e', are straps attached to the lower edge of the bandage O, onboth sides of the limb, and are confined in the slots of the brassstraps V, V', as seen in Fig. 14.

U, is a cushion bandage passing around the thigh, and through the slotst t, t t', in the cushion H, as seen in Fig. 14. It bears upon theperineum, and assists in extending the limb and keeping it securely inplace.

Te apply our splint in the following manner: 1f the fracture is betweenthe ankle and the knee, the limb is placed in the splint, the knee jointbeing placed precisely in juxtaposition with the joints R, R', and thebandages are attached as seen in Fig. 13. The limb being firmly confinedbelow the knee by the bandage O, and above the ankle by the bandage Q,is then gently extended to the point necessary to enable the operator toadjust the fractured bones, by means of the extension screws e, e', andtheir various attachments, as above described. In this position it maybe straightened, if necessary, by straps passing around the limb, andeither of the leg side pieces A, A, as it may be necessary to draw thelimb to the right or left. By the means above described, the limb iskept in the precise position desired by the operator.

If the fracture is of the thigh bone, or if the thigh is dislocated, thelimb is placed in the splint, the femur splint E, being added, and thebandages are applied as seen in Fig. 14. lIhe limb, being firmlyconfined by the bandage :0, above the knee, is gently extended to thedegree required, by means of the upper extension screws r, r, the formerbearing upon the bolster L, which rests against the perineum and alsothe bandage U, which also aids in the extension of the limb, as seen inFigs. 1 and 14. The lower part of the femur splint E is allowed to slidein the clamps n, n', until the limb is sufliciently extended, and thenit is firmly confined by the nuts q, Q, Q, q" The femur splint E, may beadjusted to either limb, as the case may require. After the reduction ofthe fracture, straps or cushions may be applied to straighten or flexthe limb either way, as may be necessary.

If the comfort, or convenience, of the patient requires the iiexure orextension of the limb, it is accomplished by the use of the elevatingscrew c, which, acting upon the leg side pieces A, A, the femur sidepieces F, F', the supports m, m, and 0, 0, the braces t, t', theelongating arbor T, and the concave flooring N, causes the upper portionof the splint to describe a double inclined piane the apex of which isat the joints R, R, thus effecting the required elevation or depressionof the limb at the knee. In these three particulars, namely, theapplication and mode of operation of the splint when used for fracturesof the legfor fractures or dislocations of the femur, and for flexingand extending the limb, we believe our splint to be different from, andsuperior to. all other splints heretofore known.

We also believe, that great benefits will be derived from the bed in oursplint for the reception of the fractured limb, composed of the stripsof cloth 71 h, 7L, &c. In splints heretofore constructed the limb hasbeen required to be in a wooden trough, or upon a pillow, each of whichit is dificult to remove without injury to the fractured limb, and greatpain and discomfort to the patient, and which are liable to becomefilthy in consequence, more or less, of the application of washes andlotions to' the limb, which run down into the trough caus-v ing theflesh to boil, blister, and ulcerate. The use of our bed obviates allsuch objections. Any one of the strips comprising it, may be removedwithout in the least disturbing the limb, or causing pain to thepatient, and a new and clean one applied. And the operator is therebyenabled to apply lotions, or any necessarymedicaments, to any part ofthe limb. VThe limb can be practically elevated by means of the stripscomposing the bed, and any position given to it which may be necessaryfor the comfort or welfare of the patient. The heel, which, in ordinarycases of fractured limbs, is the source of much discomfort and sometimesof very great suffering to the patient, may, by the use of the bed inour splint, be kept so far elevated as to avoid pressure on any part ofit. Our bed also allows the air to circulate freely around the limb. Italso furnishes greater facilities for reducing and dressing compoundfracture than can be found in any other splint heretofore known. Thefoot frame composed of the oblique standards I, I, the bow P, and thebed h h, also secures an easy position for the foot, and protects itfrom the pressure of the superincumbent bed clothes. In theseparticulars, also, we believe our splint possesses facilities andadvantages which are not to be found in any other hitherto discovered.

Having set forth above the peculiar form and construction of our splint,and its various parts, and their modes of operation, what we claim asour invention and desire to secure by Letters Patent, are

1. The bed, composed of the strips of cotton cloth It, 7L', 72,, &c., orother suitable material, passing through the slats z' z' im, iii", iz'v, &c. in the bed side pieces A, A', arranged and confined as abovedescribed, and for the uses and purposes above set forth.

2. The foot frame and bed composed of the oblique standards I, I, thebow I?, and the strip of cloth t 7L, or other suitable material, passingthrough the slats z' z, z' z", at- Y tached to and adjustable upon theleg side pieces A, A, and for the purpose and uses, as above described.

3. The device Afor vextending the leg by the employment of the lowerextension screws c, e the traversing nuts j j, and their guide, 7c, c,with their connecting straps a', 03.', 00', in combination with thecross bars J, and K, the leg side pieces A, A', the femur side pieces F,F', the femur splint E, the cushions Gr andH, the bolster L, thebandages U and O, with their connect-- ing straps, and the brass strapsV, Vf', constructed and operating in the form and manner abovedescribed.

4. The device for extending the thigh, by the employment of the upperextension Screws r, 1^', in combination With the femur side pieces F, F,the leg side pieces A, A', the femur splint E, the cushions Gr, and H,the bolster L, the bandages U, and O, with their connecting straps, andthe brass straps V, V, constructed and operated in the form and mannerabove described.

5. The device for flexing and extending the limb, by the employment ofthe elevating screw c, and its supports y, y, in combination with thecross-bar M, the leg side pieces A, A', the femur side pieces F, F, thesupports m, m', and o, 0, the braces t, t, the elongating arbor T, theconcave flooring N, and the bed pieces B, C, and D, constructed andoperating in form and manner above described.

6. The elongating arbor T, constructed and operating in form and manner,as above described.

7. The device for spreading and contractassinO' throu 'h a corres ondin'mortise in C b the upper end of the bed piece C, and the confining pin7c le, in combination With the bed pieces B, C, and D, the supports m,lm

and 0, 0, the braces t, t, the elongated arbor T, the femur side piecesF, F, the leg side pieces A, A', and the cross-bars J, and K,constructed and operating in form and manner, as above described.

JOHN CLOUGH. DANIEL M. CUMMINGS.

Vitnesses:

AMos M. BRYANT, HORACE D. CLoUGI-I.

